1. Specialist Clinics Access Policy Implementation Project Forum Thursday 22 nd May, 2014

2. About GV Health... GV Health serves a catchment of approx 120,000 people from Northern Victoria and Southern NSW Inpatient Services provided include:  acute care,  intensive care and  emergency services,  children's services,  maternity services, and  mental health services. Specialist Clinics include:  Orthopaedic Consultant Services  Surgical Consultant Services,  Gynaecological (Women's Health) Services,  Paediatric Consultant Services,  Medical Consultant Services,  Satellite Services (visiting monthly or quarterly)

3. Priority Areas for Implementation 1. Referral Acknowledgment 2. Communication with referrer about the findings of initial assessment/treatment 3. Discharge Summary sent to referrer and/or other provider Challenges 1.Clinical Nurse Specialists for triage limited 2.Intake Referral time is limited for admin staff 3.Room availability 4.Dr availability for triaging letters is not consistent Issues: 1.Project resourcing – additional staff have been recruited to support project initiatives 2.Discharge Summaries and Referral Acknowledgement – current process will not meet future KPIs

4. Implementation Action Plan Project Governance: 1. Establish Project Steering Committee for SCAPI (Specialist Clinics Access Policy Implementation) Resources: 1. Recruitment of Clinical Nurse Specialists – Referral Triage 2. Recruitment of additional Customer Service Officers – to support increased administrative workload IT Solutions: 1. Reformatting of written communication to meet “SCAPI” requirements 2. Integration of communications with existing IT system – update emails with GPs Communications: 1. Education program for GPs and relevant Medical Staff on impacts of the policy 2. Develop and implement ongoing communication plan with referring medical staff Policy & Procedures: 1. Develop and implement Orthopaedic Discharge Policy

5. Current Project Status Project Area:Initiative:Status: GovernanceProject Steering Committee established ResourcingStaff recruitment ResourcingIncrease service capacity by implementation of extension to business hours – 7am start IT SolutionsReformatting of communications commenced CommunicationsProcess manuals have been reviewed – currently being updated CommunicationsReview methods and format of referral acknowledgement to GP – events list -> letter Communications Develop and implement Orthopaedic Specialist Clinic Discharge Policy CompletedTo be commenced In progress

6. Key Initiatives: Referral Acknowledgement 6.8 GV Health’s current performance:  Letter sent to patient advising of placement to waiting list  If Cat 1- Appointment letter is sent  Daily Events list emailed to GP acknowledging referral received  Rejected/service not provided/more information required –letters generated by CNS Findings:  Found that events list is unreliable as GPs constantly moving practices  Referral rejection; further information required; service not available; reconsider referral letters need to be automated to save time Project Plan:  Redesigning standard letter templates to meet Access Policy guidelines  Improved automation of such letters  Updated and improved referral guidelines for Health Professionals  Develop communication strategies with relevant stakeholders - Emergency Department and Medicare Local being main focus  Increase in staffing to allow more triage time

7. Key Initiatives: Clinical Prioritisation 7.3 GV Health’s current performance:  Intake referral nurses available for screening and triage  Implemented referral processing forms Findings:  Doctors unwilling to allow nurses to triage despite referral guidelines put into place  Doctors not always available for triaging of letters within recommended timeframe (ie: on leave visiting monthly etc) Initiatives:  Access Policy has given us a mandate to reject inappropriate referrals  Registrars also dictate letters back to referrer with alternative care options for inappropriate referrals, or those that can be managed by GP  Ultimately to improve access to our service we have improve our discharge process

8. Final slide Next steps: Finalising revised letter templates; consumer testing Updating Patient Information brochure (version 4) Developing communication with health professionals Thank you for your time SCAPI Project CNS: Amanda Exton Ph: (03) 5832 3600 email: amanda.exton@gvhealth.org.au SCAPI Project Support Officer: Leanne Cecchin Ph: 0400 141 062 email: leanne.cecchin@gvhealth.org.au